Surviving the Change

By Tamekia Reece –

It’s something many women both welcome and dread. Menopause. On one hand, it means no more hassles with monthly periods and premenstrual syndrome (PMS). On the other, menopause comes with its own symptoms, many of which women find difficult to deal with. Fortunately, there are things you can do so that the “change of life” doesn’t interfere too much with your quality of life.

 What is menopause, really?

Most people know menopause occurs when a woman’s estrogen levels plummet during her 40s or 50s. Many people mistakenly think menopause is a process that takes months or years. Menopause doesn’t take years, months or even weeks. It’s only one day. “The diagnosis of menopause doesn’t come until twelves months of you not having a menstrual cycle,” says David Bonilla, M.D., an OB/GYN at Memorial Hermann Northeast Hospital. So the day you haven’t had a period for a whole year is the day menopause starts and completes!

Although menopause itself is only one day, symptoms may occur several years earlier and after your “menopause day.” Symptoms may include hot flashes, night sweats, insomnia, depression, anxiety, irritability, headaches, joint and muscle pains, fatigue, urinary incontinence, decreased sex drive, dry skin, vaginal dryness and painful intercourse, Bonilla says. The low levels of estrogen can also increase the risk for developing osteoporosis and heart disease.

 Hormones

To manage symptoms of menopause, women commonly rely on hormone replacement therapy (HRT), a treatment in which synthetic hormones—estrogen and sometimes progestin—are used to replace the hormones a woman’s body no longer makes after menopause. HRT is available in pills, patches, injections and vaginal creams.

 Although it’s the most effective treatment to alleviate symptoms, “the American College of Gynecologists and Obstetricians (ACOG) recommends women use HRT only if they have symptoms, and they try to get you to limit it to about four years,” says Pamela Berens, M.D., professor of obstetrics and gynecology at The University of Texas Health Science Center at Houston.

The reason? The Women’s Health Initiative—a long-term national health study on postmenopausal women—showed a slight increase in the rate of breast cancer among women taking a combination of estrogen and progestin daily, and data also showed an increased rate of blood clots, heart disease and ovarian cancer.

Women who have history of blood clots, unexplained bleeding after menopause or estrogen-sensitive cancers shouldn’t use HRT, Berens says.

For women who can’t, or choose not to use hormones, there are other options to help manage symptoms.

 Healthy Weight and Diet

Many women assume weight gain is inevitable after menopause. Not true. “The increase in weight can be due to the slowing of metabolism that occurs with aging and/or a decrease in energy expenditure,” says Sharon Smalling, M.P.H, R.D., L.D., a clinical dietician at Memorial Hermann Hospital. “That’s why it’s more important than ever that women continue to exercise, and possibly increase their usual exercise regimen, and be conscientious about their food choices,” she says.

 How should women eat? An eating pattern consistent with heart health is best, Smalling says. She encourages whole grains, fresh fruits and vegetables, healthy fats, such as almonds, walnuts and olive oil, calcium- and vitamin D-rich foods, and lean meat, fish and poultry.

 Exercise

Research suggests strength training can help reduce hot flashes and headaches. Even if it doesn’t get rid of your headaches or hot flashes, strength training and weight-bearing exercises can help decrease bone density loss that occurs after menopause, Bonilla says. Exercise also promotes an overall sense of well-being that can make anxiety, insomnia and mood changes easier to handle. Bonilla suggests women aim for at least thirty minutes of moderate exercise on most days of the week.

Phytoestrogens

Phytoestrogens are estrogen-like chemicals found in plants. “When taken, they may have the same effect on menopausal symptoms as synthetic estrogen used in HRT,” Bonilla says. However, because phytoestrogens are naturally-produced, there may be fewer risks, he says.

Phytoestrogens can be found in supplements, but are also in many foods like whole grains, beans, nuts and edible seeds, leafy green vegetables and fruits.

 Isoflavones, a type of phytoestrogen found in soy-based foods like tofu, soymilk and soybeans, or in soy supplements, has been used to help reduce hot flashes.

 Herbal supplements

Research is mixed on the results but many women use herbal supplements like black cohosh and red clover to ease some menopause-related symptoms. Although herbal products are usually regarded as safe, Smalling advises caution. “If taking supplements, you must remember they aren’t regulated by the FDA,” she says. She recommends purchasing only name brand supplements that are pharmaceutical-grade or have been tested by an independent laboratory and confirmed to contain exactly what the bottle says. It’s also a good idea to discuss supplements with your doctor before taking them.

 Non-hormonal medications

Studies show Effexor and Pristiq, antidepressants, relieve hot flashes and night sweats and improve mood and sleep in menopausal women. Berens says other antidepressants may have a similar effect. Other medications used “off-label” to help manage hot flashes and night sweats are Neurontin, a pain medication, and Clonidine, a blood pressure medication, Berens says.

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